Preoperative strength training for patients awaiting total knee arthroplasty.

95% of the patients undergoing total knee arthroplasty are diagnosed with osteoarthritis. Osteoarthritis is a joint disease which is characterized by pain, loss of force and problems during activities of daily life. This can result in reduced social participation and quality of life. Current advice on preoperative training is very diverse. Some hospitals advise patient to consult a physiotherapy pre surgery, while others do not. Between physiotherapists there are huge differences in treatment. While some only train walking with aids, others perform intensive strength training. Because there is evidence that intensive strength training is beneficial post surgery, our hypothesis is that preoperative training also leads to increases in muscle strength, voluntary activation, and physical functioning. Further we expect to find indications that positive training status is related to postoperative recovery.

95% of the patients undergoing total knee arthroplasty are diagnosed with osteoarthritis. Osteoarthritis is a joint disease which is characterized by pain, loss of force and problems during activities of daily life. This can result in reduced social participation and quality of life. Current advice on preoperative training is very diverse. Some hospitals advise patient to consult a physiotherapist before surgery, while others do not. Between physiotherapists there are large differences in treatment. While some only train walking with aids, others perform intensive strength training. Because there is evidence that intensive strength training is beneficial post surgery, our hypothesis is that preoperative training also leads to increases in muscle strength, voluntary activation, and physical functioning. Further we expect to find indications that positive preoperative effects promote postoperative recovery. This study can help to shorten recovery and increase the quality of life for patients undergoing total knee arthroplasty.

All variables will be measured at:

1. 6 weeks before surgery;

2. 0 weeks before surgery;

3. 5 weeks after surgery;

4. 12 weeks after surgery.

1. Control group: Usual care according to guidelines for training subjects with osteoarthritis;

2. Intervention group: Usual care plus additional intensive strength training (6 weeks 2 days a week). The strength training consist of 4 legexercises. The number of repeats decreases from 15 to 8, but weight increases.



After surgery, both groups will receive the same exercise program.